Devon Dermatology Services, PC

Key facts

NPI

1700554235

Entity type

Organization (NPI type 2)

Primary specialty

Dermatology Physician 207N00000X

Legal business name

DEVON DERMATOLOGY SERVICES, PC

Practice address

92 Lancaster Ave Ste 120
Devon, PA 19333-1378

Phone

(610) 989-2224

NPI assigned

Aug 31, 2021

Organization subpart

No

Authorized official

Name

Jordan V Wang, MD NPI 1699129924

Title

Owner

Phone

(610) 989-2224

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan Victor Wang, MD Dermatology Physician · Devon, PA · NPI 1699129924
  Medicare reassignment Care Compare group NPD Authorized official DERMATOLOGY · PA
• Danielle M Dehoratius, M.D. Procedural Dermatology Physician · Bryn Mawr, PA · NPI 1245346873
  Medicare reassignment Care Compare group NPD DERMATOLOGY · PA
• Stephanie Slaski, MMS, PA-C Medical Physician Assistant · Devon, PA · NPI 1790182434
  Medicare reassignment Care Compare group PA

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled in PA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 3, 2022.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1700554235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 LANCASTER AVE STE 120",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 LANCASTER AVE STE 120",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331378",
            "telephone_number": "610-989-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVON DERMATOLOGY SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-989-2224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devon, PA

• Gerard P Davis, D.MIN
• Tamara Davis, RN
• Kristine B Decena, RN
• Delaware Valley Wound Care Specialists LLC
• Devereux Foundation
• Devon Family Practice LLP
• Devon Manor-Devon PA LLC
• Dine Monte Nido, LLC
• Theresa Christina Disipio
• Vincent James Distefano, MD

All providers in Devon, PA · Dermatology Physician in Pennsylvania